Bowel or fecal incontinence is the inability to control a stool until a socially acceptable time. This condition ranges in degree of severity and affects approximately 7 percent of the population. It is more common in women and occurs in a wide age range. There are a variety of treatments for fecal incontinence. Unfortunately, due to embarrassment or lack of information many people fail to seek help.
Texas Colon & Rectal Specialists (TCRS) has a special interest in fecal incontinence and strives to provide our patients with the latest treatment options. One of the advanced procedures offered for more severe cases is implantation of the Acticon™ Neosphincter or the use of Interstim® Therapy (also known as Sacral Nerve Stimulation).
Pelvic Floor Testing (Anal Manometry) – Since there are many causes of fecal incontinence, it is important to determine the cause and severity through careful history taking, physical examination and specialized testing called pelvic floor testing which may include anal manometry, rectal sensation, pudendal nerve testing and anal ultrasound. TCRS physicians utilize this group of minimally invasive tests to help determine sensation in the anal canal or rectum, measure the pressures of the anal sphincter muscles, and test for nerve damage. Visit our Pelvic Floor Center to learn more about anal manometry and other diagnostic testing.
Bowel Evacuation Programs – Education on lifestyle changes that may help lessen bowel accidents include fiber supplements, suppositories, nutrition recommendations and antidiarrheal medications if indicated.
Physical Therapy and Biofeedback – Non-invasive management of fecal incontinence can include biofeedback therapy and pelvic floor retraining with specialized pelvic floor physical therapists to help strengthen the anal sphincter muscles and improve bowel control.
InterStim® Therapy (Sacral Nerve Stimulation) – This is one of the most leading-edge technologies available for the treatment of fecal incontinence. Originally developed for the treatment of urinary incontinence, InterStim® has also been shown to significantly help fecal incontinence patients. InterStim® Therapy is an implantable unit (“below the gluteal skin”) therapy that targets the nerves that control the communication between the brain and the nerves that control bowel functions. InterStim® Therapy is usually done in two phases.
The first phase is considered the “trial phase” where a “stimulation” wire is implanted just below your tailbone (targeting the nerves that control bowel function), and this wire is attached to a small temporary “outer” device which is worn on your waistband. This external device serves like a remote control and sends mild electrical pulses to the nerves that control bowel function, helping to improve the way your bowels work. During this trial phase the patient is asked to document their bowel control functions. If significant improvement is made, an internal device is then implanted just below the skin to control the electrical stimulation of the bowel nerves. This is typically done as an outpatient procedure.
Spincteroplasty – A majority of patients with fecal incontinence have a separation of their anal sphincter muscle due to prior child birthing or prior surgery. These patients are candidates for an anal sphincter repair. Typically, patients are in the hospital for several day after surgery and there is a recovery period postoperatively of 2-4 weeks. Good outcome with less bowel accidents are obtained in this select patient population.
Acticon™ Neosphincter – The Acticon™ Neosphincter is an advanced device used to treat severe fecal incontinence when less invasive treatments have failed. A small, fluid-filled device is completely implanted within the body. Once placed, no parts are visible. It is designed to mimic the natural function of the anal sphincter muscle, giving you control over bowel movements.
Texas Colon & Rectal Specialists is one of a limited number of colorectal
groups across the nation with surgeons who can perform this type of surgery.
Not everyone requires these advanced treatments; in fact, many people require much simpler options. The first step in being treated is to have a full evaluation by one of our experienced colorectal surgeons.
Secca® – The Secca® procedure is done on an outpatient basis under sedation. Through the use of an electrode, Secca® delivers controlled radiofrequency energy to the tissues of the anal canal causing gradual improvement in the tone of the anal canal, thus helping to improve bowel control. Patients typically can resume normal activity within a few days.